Untitled Document

New Jersey Society of Health-System Pharmacists
760 Alexander Road, P.O. Box 1
Princeton, NJ 08543-0001

Change of Address: Please notify
NJSHP at once to ensure uninterrupted
membership service

My story begins in Bayonne New Jersey. I grew up and lived there until 1993 while fostering a dream to be a major league baseball player. A bad knee dictated that I abandon this dream and choose another profession. My father had always encouraged me to be a pharmacist. I followed his advice and enrolled into Saint John’s University College of Pharmacy. While in school I had a chance meeting with a hospital pharmacist who convinced me to try hospital pharmacy. I applied and was accepted as an intern at Cornell Medical Center New York Hospital for two years. Finally in 1991, I graduated from college with my B.S. in pharmacy, passed my boards and was looking for a job. I was still working at New York Hospital although my roots were in New Jersey. I began to look for a position in the Garden State. The desire to work in a teaching hospital led me to University Hospital in Newark where I was hired as a staff pharmacist.

While at University Hospital I was extremely fortunate to meet Oscar Auerbach, one the most important mentors in my professional career. Dr. Auerbach was the physician who discovered the link between smoking and cancer and was truly world-renowned. He took me under his wing and for six years I met him every day to discuss cases. He motivated me to do more and it was he who encouraged me to get my Pharm.D., which I completed in 1997. At that point I decided I wanted to try the pharmaceutical industry and was hired as a Clinical Education Consultant for Pfizer. My job was very comprehensive and I learned more about research, teaching, computers, leadership, vision and management than I could have ever imagined.

My career was growing and so was my personal life. I married my beautiful wife, Melva, in March of 1999. We settled in Kendall Park and have been very happy since. We enjoy time with both of our growing families and we are now planning to start a family of our own. During this same period I was encouraged by a colleague, Indu Lew, to become involved in NJSHP.

I was elected as the North Central Chapter President (1998). I have remained on the Board since and was honored tobe elected as Director of Legal and Public Affairs and now as President-Elect.

In 2001, I decided to leave the pharmaceutical industry and go back to my first love, hospital pharmacy. When making the decision, I knew there was one person for whom I wanted to work. That person was Pam Allen at the Saint Barnabas Health Care System. I was hired in August 2001 as the Corporate Director of Clinical Services of Saint Barnabas Health Care System. My vision of the perfect position materialized when I took this job. In my current position, I help coordinate the clinical pharmacy activities for our health system. Pam Allen is a mentor who fosters growth, education and the freedom to research ideas that are best for the profession and patients. Working for someone who is a strong advocate for pharmacy is rare and I feel lucky. Pharmacy has not been fortunate to witness many mentors but I have had more than most people. So I now have turned my energy to giving back to the profession that has given an abundance to me. Board of Directors

NJSHP WELCOMES ARTICLES AND COMMENTS ON ANY ISSUE AFFECTING HEALTH SYSTEM PHARMACY AND ENCOURAGES MEMBERS TO SPREAD THE NEWS OF THEIR ACTIVITIES, ACCOMPLISHMENTS AND INNOVATIONS BY SUBMITTING TYPE-WRITTEN RELEASES FOR PUBLICATION IN FUTURE ISSUES OF THE BULLETIN.
PLEASE E-MAIL SUBMISSIONS TO STELLA WILLIAMS AT SWILLIAM@NJHA.COM

As we are all aware the United States Congress passed sweeping legislation to the Medicare drug benefit in late 2003. Beginning in 2006, Medicare beneficiaries will have access to the standard drug benefit outlined below. The drug plan will be provided through private prescription drug plans that contract with the Medicare program.

Although drug plan sponsors may change some of the specifics of the plan, the benefit offered must at least contain the standard benefit.

Standard coverage includes:

•	A monthly premium of about $35
•	A deductible of $250
•	Coinsurance of 25% up to an initial coverage limit of $2,250
•	Copays of $2 for generics and preferred multiple source drugs and

$5 for all other drugs, or 5% of the price, once an enrollee’s out-ofpocket spending reaches a limit of $3,600.

Beneficiaries with limited savings and low incomes will receive a more generous benefit package. For instance, beneficiaries with limited savings and income below 135% of the federal poverty line ($12,123 for individuals and $16,362 for couples) will receive:

•	A $0 deductible
•	A $0 premium
•	No gap coverage
•	Copays of $2 for generics and $5 for all other drugs

Medicare-endorsed Prescription Drug
Discount Card
Medicare beneficiaries that do not have drug coverage will be eligible for the Medicareendorsed

Prescription Drug Discount Card, which will begin operation sometime in June 2004 and continue until the full benefit is implemented. The card program is estimated to save beneficiaries between 10% and 25% on most drugs. Individuals with incomes below 135% of poverty will be given immediate assistance through a Medicare-endorsed prescription drug discount card with $600 annually to apply toward purchasing their medicines

The Medicare system was developed more than 40 years ago. To that end, this is the first major change to Medicare with regard to providing a drug benefit. This bill does not offer true full coverage for our seniors; however, it is a good first step. We will continue to lobby Congress to make amendments that are commensurate with what our seniors need.

On January 1, 2004, United States Pharmacopeia (USP) Chapter <797> became the standard of practice for pharmacy compounding practices in the United States. The document, known as General Tests and Assays Chapter 797 or “Pharmaceutical Compounding-Sterile Preparations,” is the revision of the general information chapter 1206, “Sterile Drug Products for Home Use” and provides procedures and requirements for compounding sterile preparations. The chapter was moved into the General Tests and Assays portion of USP, which has chapter numbers less than 1000. The USP is a quasi-governmental agency, chartered by Congress to set official standards of drugs and have done so since 1906.

This means that <797> can be enforced by State Board of Pharmacies and used by FDA personnel to determine whether a drug has been adulterated. According to Carmen A. Catizone, Executive Director of the National Association of Boards of Pharmacy (NABP) as interviewed in AJHP, Vol 60, Sept 15, 2003, USP chapters can be enforced by a state board of pharmacy, but only if that board stipulates so in its regulations. Chapters that become the standard of practice in pharmacy can also be enforced by a state board of pharmacy, he added. The USP does not have any enforcement authority over pharmacies or any other practice settings. Historically, attorneys have used USP chapters as the standard of practice over state board of pharmacy practice acts, especially if the regulations don’t adequately address the matter being tried.

As published in the chapter’s preamble, the standards of chapter <797> apply to all practice settings (health care institutions, pharmacies, physician practice facilities and other facilities) where sterile preparations are prepared, stored and dispensed.

Patient injury and deaths have been related to compounding errors.

Although state and federal governmental agencies may not enforce USP <797>, in the event of patient injury and death, the standard of care that the provider of compounded sterile preparation will judged against USP Chapter <797>.

What should you do in order to be in compliance with USP <797>?
Obtain a copy of USP 27-NF 22 by visiting USP’s website at

http://store.usp.org/OA_HTML/ibeCCtpSctDspRte.jsp?a=b.

Eric will present this topic in April at NJSHP Chapter meetings.

Consider placing your classified ads on NJSHP’s website,
www.njshp.org. Target your ad directly to NJSHP members.
Here are the rates for this very affordable option:*

Display Ad Size	1 Month Rate	3 Month Rate	6 Month Rate
150 words or less	$150.00	$200.00	$250.00
151-300 words	$200.00	$250.00	$300.00
301-450 words	$250.00	$300.00	$350.00

*Full payment made payable to the New Jersey Society of Health-System Pharmacists must accompany all submitted advertisement. NJSHP reserves the right to discontinue any advertising schedule for which payments are not made at the time of submission. NJSHP reserves the right to hold the advertiser liable for the amount due and payable to NJSHP if funds are insufficient. All prices listed are for computer-ready art work, except where noted. Additional fees may be incurred if NJSHP provides design of any artwork or layout. To place an ad, call Stella Williams at 609-936-2205.

Three organizations, the CDC, the American Thoracic Society and The Infectious Diseases Society of America, have published separate clinical practice guidelines for the treatment of community- acquired pneumonia. These clinical practice guidelines provide evidence-based recommendations for clinicians to optimize therapy. In December 2003, the Infectious Diseases Society of America published an update of CAP. The purpose of the update is to answer questions arising from evolving antimicrobial resistance and advances in technology. The IDSA update provides information in tabular format,

along with text. IDSA guidelines update the criteria for initial selection of site of therapy; initial empiric therapy; changes in the MIC for extended spectrum cephalosporins; diagnostic test updates; SARS; bioterrorism and prevention. Here are some areas of change to note: For all inpatients, initial therapy should occur after blood and sputum cultures are obtained and the first doses of antibiotics should be administered within four hours of the decision to admit. Initial therapy for most patients remains as a macrolide with or with out a beta-lactam; or a respiratory fluoroquinolone

(gatifloxacin, levofloxacin, moxifloxacin, or gemifloxacin). An extended spectrum cephalosporin (cefotaxime or ceftriaxone) is still the recommended agent for penicillin resistant streptococcus pneumonia. The MIC has been revised for nonmeningococcal isolates of S. pneumonia. A MIC <= 1 mcg/ml is now considered sensitive, MIC = 2 mcg/ml is intermediate, MIC > 4mcg/ml is resistant. The prior MIC breakpoints were reflective of the need to maintain higher concentrations to cross into the CNS. Pharmacists should consider the new MIC breakpoints when making recommendations.

The ASHP Product Reseller Program is an avenue to help the Society generate additional revenue. To date, through this program, the Society has generated over $4,000. Purchasing ASHP products through the Society is an easy way to financially support your State Chapter of Health-System Pharmacists. If interested, please call the office at (609) 936-2205 to request a copy of the product listing and product order form.

Four members of NJSHP have been elected to serve as New Jersey delegates at the ASHP Annual Meeting, scheduled for June in Las Vegas, Nevada. They are: Charles Arrison, Cathy Hansen, Eric Hola, and Paul Malacrida.

Dr. Joseph Barone was awarded the ACCP Education Award on 11-02-03. He is the fifteenth recipient of the award which recognizes an ACCP member who has shown excellence in these areas: classroom or clinical training site; innovative research in clinical pharmacy education; exceptional dedication to clinical pharmacy continuing education, or leadership in the development of clinical pharmacy education programs. The ACCP Education Award is indeed a distinguished honor. Dr. Barone was selected among the ACCP’s 7800 members. NJSHP congratulates Dr. Barone on this accomplishment!

Please note that the author of “Summary of Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7)” from the Fall 2003 Newsletter is Indu Lew, Saint Barnabas Health System Biotechnology Fellow. NJSHP apologizes for this omission.

As the President of the NJSHP student Chapter, I am often asked, “What does the Student Chapter do”? More often than not, I describe our monthly meetings, student attendance at monthly state chapter meetings, activities that occur each semester as well as promote the Annual meeting. However, I now believe I can proudly respond to the above question with, “…what the students want”! Case in point, at the end of each of our monthly meetings, the floor is opened to all those who attended so that I can find out if anyone has ideas for new activities or speakers for the future. Silence often follows as people make their way on home. However, after our first meeting this past September, I was approached by several student members who wanted to know more about rotations, especially a student’s perspective (experiential learning that occurs during the 6th-year of pharmacy school at Rutgers). I thought this was a good idea, ran it by my officers for their approval, and put it on the back burner while we proceeded with coordinating and executing previously planned events. However, as November approached and we completed the annual ASHP Clinical Skills Competition and Halloween Children’s visit, I began to think about what to do for November. Then it hit me, we should do what the members want! Thus, I proceeded with all of the necessary details to organize an event as well as finding current 6th-year NJSHP members to speak. Also, we decided to invite several faculty members who take students on rotations so that the audience could hear their perspectives on rotations. Needless to say, the NJSHP Student Chapter’s November event entitled, “Perspectives on Rotations,” was one of the most successful programs created by the student chapter during my four years as a member of NJSHP. I have since received only positive feedback from students in attendance as well as the 6th-year students and two outstanding faculty members

Continued on back cover

President, Paul Malacrida
Saint Barnabas Health Care System, (973) 322-4367

President-Elect, Robert Adamson
Saint Barnabas Health Care System, (973) 322-4393

Secretary, Helen M. LoSasso
Kennedy Health System - Stratford Campus, (856) 346-7917

Treasurer, Beverly Wilt
Kennedy Health System – Washington Township Campus, (856) 582-2531

Immediate Past President, Carlo P. Lupano
The Valley Hospital, (201) 447-8123

Educational Affairs, Richard Artymowicz
Burdette Tomlin Memorial Hospital, (609) 463-2720

Organizational Affairs, Mitch Sobel
Saint Barnabas Health Care System, (973) 322-5136

Legal and Public Affairs, Robert Adamson
Saint Barnabas Health Care System, (973) 322-4393

Professional Affairs, John Yanoschak
Memorial Hospital of Burlington County, (609) 267-0700 Ext. 43154

Technician Affairs, Barbara Dixey
Jersey Shore Medical Center, (732) 776-4286

ADMINISTRATIVE DIRECTOR
Stella Williams, (609) 936-2205

CHAPTER PRESIDENTS

Northern—Andrea A. Morales
Hackensack University Medical Center, (201) 996-2242

North Central—Kevin Carl
Novartis Pharmaceutical Corp., (973) 781-8165

Central—Marsha Durniak
Somerset Medical Center, (908) 595-2626

Southern—John Yanoschak
Memorial Hospital of Burlington County, (609) 267-0700 Ext. 43154

Student Chapter—Daniel T. Abazia
Ernest Mario School of Pharmacy

	*NJSHP call for new members* By Mitch Sobel, R.Ph., Director of Organizational Affairs
	Our Society represents the interests of the health-system pharmacists, pharmacy technicians, and supporters of pharmacy in the State of New Jersey. The board members volunteer their time and efforts to represent the views, the concerns, and the needs of the health-system pharmacist and pharmacy technicians before the New Jersey State Board of Pharmacy, and the New Jersey legislature. The NJSHP strives to increase the public awareness of the role of the health-system pharmacist in the pharmaceutical care and treatment of patients within our communities. Our most recent success is the lobbying efforts used to help pass the Pharmacy Practice Act. This act will prove to be monumental with respect to how our profession practices pharmacy and cares for our patients. The New Jersey Society of Health-System Pharmacists needs your support. NJSHP needs our health-system pharmacy leaders to set the example of collaboration, education, and motivation for all pharmacy health-care providers. We need you to inspire others to join and explain the many benefits our Society offers. There are four chapters in the various geographical areas of the state for the convenience of attending the monthly meetings. In response to regulations requiring 5 live continuing education credits per year, NJSHP offers ACPE credits at no additional charge to our membership. Membership also includes midyear and annual meetings with CE credits, networking opportunities, and the prospect to share ideas with other health-system pharmacists throughout the state. It is only with your participation and support that will lead others to help NJSHP grow and promote the profession of health-system pharmacy. Please log onto www.njshp.org or call Stella Williams, Administrative Director of NJSHP at (609) 936-2205 for information, answers to questions or for membership forms. If you have any questions please contact me at (973) 322-5136 or e-mail me at msobel@sbhcs.com. Our greatest product is in our membership; our greatest asset is the involvement of your leadership and professionalism. Please join and inspire others to join today.

The Student Scene Continued from previous page

donated their time to speak and answer all of our questions. The Dean of the school, Chairman and Vice-chairman of the Pharmacy Practice Department also voiced their praise for the program. I even received an email from a student who couldn’t attend asking when we are going to repeat this program.

Describing this event is not to illustrate how my officers and I can create a successful student-oriented program. It is to illustrate how the NJSHP student chapter is a student-run chapter. The NJSHP officers are proud to lead the organization and provide worthwhile events/activities for its members and the student body as a whole. But, as officers, we are not the organization; the members are the organization. They make (or break) the chapter. And presently, they are doing a great job!

NJSHP Acknowledges These 2003 Corporate Sponsors:
	PLATINUM
Amgen USA Patrick Sabino psabino@amgen.com 908-770-0745		NJHA Corporate Services George Hartpence Ghartpence@njha.com 609-936-2197
	GOLD
MGI Pharma, Inc . James (Jim) Pitt jpitt@mgipharma.com 1-800-562-0679 Ext. 4102	Roche Laboratories Debbe Bach 401-831-2666	Ortho Biotech Claudia Stivale cstivale@obius.jnj.com 1-800-588-4646 Ext. 8983

If your organization is interested in learning more about the benefits anNJSHP Corporate Sponsorship offers, please contact Stella Williams today at609-936-2205 or visit our website at www.njshp.org.

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